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Medicare Improper Payments Fall to Lowest Since 2010

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Improper payments by Medicare in fiscal 2018 dropped to their lowest rate since 2010, the Centers for Medicare and Medicaid Services (CMS) said Friday in a report flagged by Modern Healthcare.

CMS paid an estimated $31 billion in improper payments over fiscal 2018, which represents 8.12 percent of all payments — down $4.59 billion from 2017, when improper payments accounted for 9.51 percent of total Medicare Fee-for-Service claims.

Improper payments include fraudulent claims, payments made to the wrong recipient or for the wrong amount, payments with insufficient documentation, and those when the recipient uses the funds improperly, Modern Healthcare’s Virgil Dickson explains.

Improper payment rates dropped for Medicare Fee-For-Service (FFS), Medicare Part C, Medicare Part D, Medicaid and the Children’s Health Insurance Program, the first time on record that’s happened for all five programs, CMS said.